| NPI | 1205077641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA NICOLE BRANNON Clinical Psychologist 803-422-6608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY7880) |
| Enumeration Date | 2009-03-16 |
| Last Update Date | 2009-08-05 |